| NPI | 1376627273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: FL 23470) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 5150) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2007-08-07 |